Comparison Between Open and Laparoscopic Technique in the Management of Perforated Gastroduodenal Ulcers

Abstract

Laparoscopic treatment of perforated gastroduodenal ulcers is an effective treatment option and should be considered in suited patients for the initial approach.

Outcome of laparoscopic repair of perforated duodenal ulcers

“…(18) Studies from Europe, however, reported older patients and a much lower male predominance. (18)(19)(20)(21)(22)(23) The conversion rates of laparoscopic surgery to open repair have been reported to range from 0% to 27%, (5,6,18,(23)(24)(25)(26)(27)(28) which are comparable to the rate of 10.3% (22/213) in our study. The reasons for conversion in our series included excessive peritoneal contamination (n = 14), adhesions (n = 5) and inadequate ulcer localisation (n = 3).…”

“…(2) Although different techniques of ulcer repair have been described, suture repair of the perforation with an omental patch is the most popular technique. (3,4) Other types of laparoscopic repair include single-stitch laparoscopic omental patch repair, (2) simple repair alone, (5) the suture-less technique, (6) stapled omental patch repair, (7) laparoscopic repair with a falciform ligament patch (8) and gastroscopy-aided repair. (9) Studies on laparoscopic repair of perforated peptic ulcers with minimally invasive techniques have shown decreased postoperative analgesia requirements, lower incidence of wound infection, shorter hospital stay and earlier return to work.…”

The simple suture laparoscopic repair of peptic ulcer perforation without an omental patch

“…For three patients who had adhesions caused by chronic cholecystitis, technical difficulty because of inappropriate ulcer localization, or diabetes mellitus with a high MPI and a 12-mm perforation, the laparoscopic surgery was converted to conventional open surgery [2,3]. Although Seelig et al [4] did not use any selection criteria for laparoscopic repair without an omental patch, they observed one leak in the 21 patients in their study.…”

Laparoscopic and open repair of perforated peptic ulcer

“…1 The most common complication of peptic ulcer disease includes bleeding, perforation and obstruction with perforation being second most common complication as well as second most common cause of bowel perforation after acute appendicitis. Perforation of duodenal ulcer will lead to contamination of peritoneal cavity with bile as well as free air.…”